Silverado, Symphony Senior Living CEOs Envision New Era of Memory Care

New memory care treatments and diagnostic tools. Promising technology. More resident-centric programming and operations.

These and other advances have pushed memory care into a new era, with the leaders of two senior living companies, Silverado and Symphony Senior Living, leading the charge in the sector’s next evolution.

The Memory care product type was hit hard by Covid-19, and operators in the sector saw some harrowing challenges during the pandemic’s darkest days. Although the sector is now on the mend after one of its toughest-ever periods, there is a sense that operators across the industry must rethink operations for a new generation of residents.


As he surveys the senior living landscape, Silverado CEO Loren Shook sees many exciting advances on the horizon. And foresees a day in the not-too-distant future where operators across the industry can use these and other tools to substantially improve resident outcomes.

“We have some tools that are coming that are really exciting that will help us,” Shook said during the inaugural Senior Housing News BRAIN event in Chicago. “If you are in independent living or assisted living, and you can tell somebody has pre-dementia, and you can stop that — that’s pretty cool.”

Hard-won experience

The Covid-19 pandemic has kicked off a new era for memory care operators, in both good and bad ways.


On the one hand, operators in the sector have more challenges than perhaps ever before with regard to staffing, infection control and programming. On the other hand, these challenges have given some operators a chance to hone their practices and elevate their services.

For Symphony Senior Living, the pandemic created some operational chaos early on. Like some other operators, the company “bubbled up” its four memory care communities in Canada early on, effectively sealing them off from the outside world.

At BRAIN, CEO Lisa Brush recalled some of the pandemic’s early challenges, including having a community where three-fourths of the workers there quit within the same week. The company also in that time parted ways with a house doctor who wouldn’t stop making in-person rounds, despite the need for physical distancing.

But Symphony emerged from its hardest days during the pandemic with stronger practices as a result, and validation that the company can overcome adversity.

“We realized … all the things we know as good memory care providers — guess what? They work, they really work,” Brush said.

Symphony/Blue Lotus Senior Living CEO Lisa Brush; photo by Robotoaster for Aging Media Network

Shook said Silverado and the company’s nearly 30 communities faced similar challenges during that time, which resulted in new practices for the future.

For example, the company during the pandemic began tasking med techs with passing medication to residents, not nurses as it had done before. Silverado also began handling some functions in its home office, going from about 30 business managers to just three.

“And the result was a huge improvement in cash, collections, and family satisfaction,” Shook said.

But like Brush, Shook said the bigger takeaway from those challenges was how resilient the company’s staff are.

“If you ever needed a reminder of what heroes you worked with, Covid was it,” he added. “We actually came out a bit stronger.”

New era of memory care

With some of the challenges of the Covid-19 pandemic still at hand — expenses and staffing to name two big ones — the leaders of both operators see a real need to stay nimble and innovate for the future. And in that regard, leaders of both companies also see many potential avenues for innovation and disruption ahead.

One such avenue is Aducanumab, which is sold under the brand name Aduhelm. While the Alzheimer’s treatment was approved by the FDA in a controversial move last year, Shook believes it is an important step in advancing treatment options for residents living with different cognitive challenges.

But he also believes “the real exciting stuff isn’t in the drugs,” but instead in diagnostic tools on the forefront of the industry. For instance, Shook said there is plenty of research underway to detect and diagnose Alzheimer’s and other forms of dementia earlier than they are today.

“There is one researcher that is pretty sure that they can tell pre-symptom if someone has dementia with a test,” Shook said.

Silverado CEO Loren Shook; photo by Robotoaster for Aging Media Network

He added that while much of that research is still under consideration, any effective way to diagnose cognitive diseases before an older adult shows symptoms would represent a “game-changer.”

Silverado employs a program called Nexus, which is meant to help support brain health of people living with the early stages of dementia. Shook said the program is documented by University of California San Diego (UCSD) and he added that there is evidence it can slow the progression of dementia and improve cognition.

Typically, that is a treatment initiated when a resident first shows signs of dementia. But with a better diagnostic tool, memory care operators could more effectively mitigate the disease’s effects.

“If you know pre-symptom that somebody has dementia — Alzheimer’s disease, for example — you could do things to slow the progression,” Shook said.

He also sees a bigger role for technology in the new era of memory care. Shook noted that artificial intelligence could help pick up on patterns in gait, eye movement and speech patterns that might detect dementia earlier.

“If you’re in a memory care [community], and you can, by enhancing cognition … slow the progression, increase the quality of life — the ADLs are even better than the cognition scores — that’s a new day,” he said.

And Shook is heartened by the fact that there are also many ways to manage residents without relying on prescription medications. For example, he said small doses of cannabis edibles can help calm agitated residents in memory care.

“For somebody who is … having a little problem in the afternoon, it’s amazing what a gummy bear will do,” he said.

Brush echoed many of those sentiments, and added that any help in detecting dementia earlier and slowing its progression would be a big win for the industry.

“The sooner you can know, the more information we can have earlier, then people can make their own decisions,” she said.

Brush also sees a future where these and other memory care advances can play a role managing residents in other care settings, such as independent living or assisted living, and help them age in place instead of immediately moving to a memory care setting.

“So I think there are going to be some more interesting environments, not necessarily prettier buildings,” she said.

Although Shook doesn’t believe any one treatment or practice will be a magic bullet to solving challenges in memory care, he is excited about all of the different advances right around the corner.

“It’s going to be programming and engagements and stimulation in a brain healthy environment that makes the difference,” Shook said.

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